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Background

We aimed to determine medications’ comparative efficacy and safety for adults with alcohol use disorders.

Methods

We searched eleven electronic data sources for randomized clinical trials with at least 4 weeks of treatment reporting on alcohol consumption (total abstinence and reduced heavy drinking), dropouts, and dropouts due to adverse events. We conducted network meta-analyses using random-effects, frequentist models, and calculated summary rate ratios (RRs) with 95% confidence intervals (CIs).

Results

We included 156 trials (N= 27,334). Nefazodone (RR= 2.11; 95% CI, 1.42–3.13), aripiprazole (RR= 1.97; 95% CI, 1.36–2.88), carbamazepine (RR= 1.85; 95% CI, 1.03–3.32), and nalmefene (RR= 1.17; 95% CI, 1.01–1.35) were associated with the most dropouts. Baclofen (RR= 0.83; 95% CI, 0.70–0.97) and pregabalin (RR= 0.63; 95% CI, 0.43–0.94) caused fewer dropouts than placebo …